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General NPI Number Information
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NPI Number | 1043338239
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Entity Type | Organization
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Legal Business Name | BETTE GLICKFIELD PHD PLLC
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 11/05/2024
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Provider Practice Location Address
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Address Line | 5600 WEST MAPLE RD STE D407
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City | WEST BLOOMFIELD
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State | MI
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Zip | 48322-3711
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Country | US
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Telephone | 248-851-2262
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Fax |
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Provider Business Mailing Address
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Address Line | 3160 PARKLAND DRIVE
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City | WEST BLOOMFIELD
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State | MI
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Zip | 48322-1823
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Country | US
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Telephone | 248-851-2622
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED DELEGATE/ PSYCHOLOGIST
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Name | BETTE GLICKFIELD
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Credential | PHD
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Telephone | 248-535-8547
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 6301005241
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License Number State | MI
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